- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.17 / $472.17 / $4,828.00
| Facility | | $472.17 | $472.17 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,325.04 / $5,396.85 / $11,503.06
| Facility | | $2,325.04 | $5,396.85 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.73 / $1,625.63 / $3,910.66
| Facility | | $1,145.73 | $1,625.63 | $3,910.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.57 / $1,486.21 / $3,079.26
| Facility | | $1,041.57 | $1,486.21 | $3,079.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.40 / $810.49 / $3,293.00
| Facility | | $485.40 | $810.49 | $3,293.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |